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Know Your Diabetes Treatment Options

Managing diabetes is a balancing act. From lifestyle adjustments and medication to insulin treatment, understanding your diabetes treatment options can help you stay a step ahead of your disease.

There are many different ways to manage and treat diabetes. Some of them involve adopting healthy lifestyle habits while others focus on medication. When it comes to understanding your treatment options, your doctor is an important partner who can work with you to determine which treatments are right for you and when your regimen may need adjusting.

How Diet and Exercise Can Help

With type 2 diabetes, your body may make insulin, but it doesn't use that insulin properly. This is called insulin resistance. There are several diabetes treatment options that can help your body become more sensitive to the insulin it produces.

"Diet, meal planning, and regular exercise are the foundation for managing type 2 diabetes," says Leann Olansky, MD, an endocrinologist at the Cleveland Clinic in Ohio. "Some people don't need any other forms of treatment for a long time. Whatever therapy we do give them will also work better if they exercise and watch what they eat."

At the top of the list is avoiding foods high in sodium, sugar, and fat. Opt for complex carbohydrates that are broken down into glucose (sugar) more slowly. Your meals should include a variety of fiber-rich whole grains, fresh produce, and lean proteins.

Increasing your physical activity can help you lose weight as well as reduce your insulin resistance. "Exercise uses glucose in a way that doesn't require much insulin," Dr. Olansky says. "Whatever exercise you do is beneficial for overall insulin responsiveness. Just 30 minutes of exercise four to five times a week has been shown to be beneficial."

When talking with your doctor about exercise, ask whether weight training might be helpful for you. Studies have shown that greater muscle mass improves insulin sensitivity. One study, published in 2013 in the Journal of Applied Physiology, found that doing resistance training to build muscle reduced body fat and improved insulin sensitivity, even without weight loss.

Oral Medication Options

If diet and exercise aren't enough to control your diabetes, your doctor may prescribe medication. You may even need to take more than one drug to keep your blood sugar levels within a normal range. "They have an additive effect," Olansky says.

Among the medications that may be prescribed as part of your diabetes treatment are:

Metformin: This drug helps prevent the liver from releasing glucose and improves insulin sensitivity. Metformin, which is in a class of drugs called biguanides, is often the first treatment used in managing diabetes.

Thiazolidinediones: Taken once or twice a day these drugs help improve your insulin sensitivity and can also slow the release of glucose from the liver.

DPP-IV inhibitors: These drugs affect hormones that trigger insulin production and slow the production of glucose by the liver.

Sulfonylureas: These drugs prompt your body to produce more insulin to help keep your blood sugar under control.

Alpha-glucosidase inhibitors: These drugs slow the absorption of glucose in the digestive tract to help control your blood sugar levels.

SGLT2 inhibitors: The newest oral medications used to treat diabetes, SGLT2 inhibitors prevent the kidneys from absorbing excess glucose into the bloodstream.

Injectable Diabetes Medication

“Injectable medications are often the second choice after metformin for people willing to take injections," Olansky says. Although they may cause some initial nausea, injectable diabetes medications have the added benefit of weight loss — an average of 8 to 10 pounds.

Available injectable diabetes treatments include:

Exenatide and liraglutide: These drugs increase insulin production when blood sugar is high and slow the production of glucose by the liver.

Pramlintide: This medication slows digestion and prevents blood sugar levels from spiking after a meal. It also triggers the production of insulin and slows production of glucose by the liver.

Insulin Treatment Options

Over time, diet, exercise, and oral or injectable medications may no longer be enough to keep your blood sugar levels within a normal range. When this happens, your doctor may recommend insulin as a diabetes treatment option.

Although scientists are working to develop insulin that can be safely and effectively taken as a pill or inhaled as a spray, insulin must currently be given under the skin through a syringe or with an insulin pen or pump.

Your doctor can help you figure out which insulin delivery method would work best for you. It's also important to speak with your doctor about any concerns you have regarding your medications or your ability to stick to your treatment plan. This will help your doctor develop the most effective treatment regimen for you.